White House targets CHIP, CMMI for budget cuts

The White House is requesting cuts of about $7 billion to the Children’s Health Insurance Program as part of $15.4 billion budget cut using a rare maneuver known as rescission.

The package also includes an $800 million cut to the Centers for Medicare & Medicaid Innovation (CMMI), a policy incubator that the Centers for Medicare & Medicaid Services uses to test innovative payment approaches.

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According to the rescission request sent to Congress on May 8, the CHIP cut is comprised of more than $5.1 billion “in amounts made available by the Medicare Access and CHIP Reauthorization Act of 2015 to supplement the 2017 national allotments to states, including $3.1 billion in unobligated balances available on Oct. 1, 2017, and $2 billion in recoveries as of May 7, 2018.”

These funds were a one-time, additional appropriation “to reimburse states for eligible CHIP expenses.” According to the rescission request, the authority “to obligate these funds to states expired on Sept. 30, 2017, and the remaining funding is no longer needed.”

A second request would rescind nearly $1.9 billion from the Child Enrollment Contingency Fund, which provides payments to states that experience shortfalls from higher-than-expected enrollment. The White House notes that there were $2.4 billion available as of March 23, 2018, and that CMS “does not expect that any state would require a contingency fund payment in fiscal year 2018; therefore, this funding is not needed.”

If enacted, these rescissions “would have no programmatic impact,” according to the White House.

A broad coalition of physicians’ organizations and other advocates protested the proposed cuts in a May 9 letter to Congress.